=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891390340
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AIELLO FAMILY CHIROPRACTIC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/02/2020
-----------------------------------------------------
Last Update Date | 01/19/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7127 CROSSROADS BLVD STE 102
-----------------------------------------------------
City | BRENTWOOD
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37027-2827
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-945-6416
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7127 CROSSROADS BLVD STE 102
-----------------------------------------------------
City | BRENTWOOD
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37027-2827
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-945-6416
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | EUGENE ALAN AIELLO
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 615-945-6416
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------